Physicians Need to Work as a Symphony in Medicine

I love to attend the symphony.  Being devoid of musical talent I possess an almost childlike awe of the orchestra, their skill and dedication seeming otherworldly to me, existing on an ethereal plain higher than my own, unattainable by mere mortals.

If you listen only to digital music, it is difficult to appreciate the texture of a live orchestral performance; its analog corpus alternately soft and silky, then disconsonant,  then soaring to grand heights, enveloping you in a way that makes it difficult to even discern from whence the sound emanates, evoking emotional responses unobtainable by the spoken word.

I am also fascinated to observe the musicians, the ensembles playing in perfect unison, one moment instruments unmoving, frozen at the ready, the next surging into frenetic activity, the sound rising to the heavens.  If ever your gaze has rested on the violins in Dvorak’s 7th or the French horns in Mahler’s 6th, the image is clear. Likewise the other instruments, their masters at one moment in repose, the next leaping to action seem controlled by an unseen puppet master each contributing its voice to the sublime totality of the music.

I believe that physicians, and medicine in general are viewed by those outside our chosen field in an analogous fashion.  We are held as a group to be unusual, set apart, possessing characteristics beyond those of society in general, sometimes viewed in awe, our decisions not questioned, given special latitude by these attributed characteristics that we may not actually possess.

In our finest moments we, like musicians in an orchestra, play together eloquently, our talents complementing those of our colleagues, our skill delivered exactly on cue.  The collaboration of team care in heart failure, the ballet of imaging and interventionalist in transcatheter aortic valve replacement and our medical systems response to the disasters of the Boston marathon and West, Texas are shining examples.

But unfortunately in most situations we fail to play well together; petty differences disrupting our performance, that far greater purpose of our nation’s healthcare.

We are all able to cite examples: the fratricide of one cardiology group in open hostility with another, the denigration of one physician specialty by a complimentary physician specialty and the all too familiar moniker of the “LMD” by our academic colleagues come to mind.

Sadly, we have no one to blame but ourselves, since we are the problem.

We have lost our collective way, failing to seize and implement our most powerful instrument, our professions singular, unwavering, uplifting score. We are the symphony of altruism, our 3,000 year old ethical and moral underpinnings our metronome, our selfless responsibility to our fellow man our allegro, our individual specialties merely the instruments of our orchestra.  It is those very characteristics that have given us such a valued place in society.

But all is not lost for it is within our grasp to regain our harmony, our cohesiveness, our unified purpose.

To do so, we simply must lead, not follow.  Selflessly, arm in arm, the greater societal good our Polaris, eschewing personal gain, focusing our attention to the real problems of health care is our calling.

Let us not fail.

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